Comparative Study of CO2 Laser and Curettage-Electrodesiccation for Superficial Basal Cell Carcinoma Treatment: A Focus on Cosmetic Results.

Abstract

Introduction: Basal cell carcinoma (BCC) is the most common type of skin cancer worldwide, and the incidence is rising. While surgical excision remains the gold standard, it can be time-consuming and resource-intensive. Therefore, there is a growing need for simpler and more cost-effective treatment options for low-risk tumors.

Objectives: This study compared the scar quality and the recurrence rate from continuous wave CO₂ laser and curettage and electrodesiccation treatments. Scar quality and the recurrence rate from the treatments were assessed.

Methods: A single-blind randomized prospective interventional trial was conducted at Odense University Hospital, Denmark, from 2017 to 2023. Patients with histologically confirmed superficial BCC were randomized 1:1 to Curettage-Electrodesiccation (CE) or continuous wave CO₂ (CW CO₂) laser treatment. Scar quality was assessed using the Patient and Observer Scar Assessment Scale (POSAS) and a modified visual-only scale (VSAS). Recurrence within one year was a secondary outcome.

Results: Thirty-two patients were treated for 32 tumors: 17 with CE and 15 with CO₂ laser. There was no significant difference in scar quality or recurrence rate between the CE and CO₂ laser groups (PSAS: P = 0.422; OSAS: P = 0.747; VSAS: P = 0.522). After one year, neither group showed tumor recurrence.

Conclusion: CO₂ laser used in continuous wave setting offers a treatment for superficial BCCs with cosmetic outcomes and recurrence rates comparable to CE. However, a larger patient sample and longer follow-up are needed for definitive conclusions.